Coping Up With Neuropathic Pain
What is neuropathic pain?
Your nervous system may experience neuropathic pain if it is injured or not functioning properly. Any level of the neurological system, including the brain, spinal cord, and peripheral nerves, can cause pain. The central nervous system is comprised of the brain and spinal cord. The rest of your body's peripheral nerves are found in areas including your organs, arms, legs, fingers, and toes. Incorrect signals are sent to pain areas by damaged nerve fibers. At the site of the nerve damage and in other areas of the central nervous system, nerve function may vary.
What are some of the sources of neuropathic pain?
Neuropathic pain can be caused by diseases, including:
- Facial nerve problems.
- HIV infection or AIDS.
- Central nervous system disorders (stroke, Parkinson’s disease, multiple sclerosis, etc.)
- Complex regional pain syndrome.
- Shingles. (Pain that continues after your bout with shingles ends is called postherpetic neuralgia.)
Other causes include:
- Chemotherapy drugs (cisplatin, paclitaxel, vincristine, etc.).
- Radiation therapy.
- Amputation, can cause phantom pain.
- Spinal nerve compression or inflammation.
- Trauma or surgeries with resulting nerve damage.
- Nerve compression or infiltration by tumors.
What are the symptoms of neuropathic pain?
Many symptoms may be present in the case of neuropathic pain. These symptoms include:
- Spontaneous pain (pain that comes without stimulation): Shooting, burning, stabbing, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling
- Evoked pain: Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc. This is called allodynia. Evoked pain also may mean the increase of pain by normally painful stimuli such as pinpricks and heat. This type of pain is called hyperalgesia.
- An unpleasant, abnormal sensation whether spontaneous or evoked (dysesthesia).
- Trouble sleeping, and emotional problems due to disturbed sleep and pain.
- Pain that may be lessened in response to a normally painful stimulus (hypoalgesia).
How is neuropathic pain diagnosed?
Your doctor will do a physical examination and take a medical history. Your doctor will be able to tell if you have nerve damage if they are aware of it or suspect it. Then, your healthcare professional will track the symptoms of the neuropathy and attempt to determine its underlying cause.
How is neuropathic pain treated?
The goals of treatment are to:
- Treat the underlying disease (for example, radiation or surgery to shrink a tumor that is pressing on a nerve).
- Provide pain relief.
- Maintain functionality.
- Improve the quality of life.
Neuropathic pain is typically treated with multimodal therapy, which may include medications, physical therapy, psychiatric counseling, and occasionally surgery.
Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as:
- Gabapentin (Neurontin®)
- Pregabalin (Lyrica®)
- Topiramate (Topamax®)
- Carbamazepine (Tegretol®)
- Lamotrigine (Lamictal®)
Doctors also prescribe antidepressants such as
- Amitriptyline (Elavil®)
- Nortriptyline (Pamelor®)
- Venlafaxine (Effexor®)
- Duloxetine (Cymbalta®)
Anti-seizure medication or antidepressants may be prescribed by your pain expert, but this does not necessarily indicate that you have seizures or are sad. However, despair or anxiety can indeed exacerbate chronic pain. The painful area can be treated topically with patches, lotions, or ointments containing lidocaine or capsaicin. Because of its unfavorable side effects, opioid analgesics are less effective at treating neuropathic pain.
Additionally, the pain may be managed using nerve blocks administered by pain experts, such as steroids, local anesthetic, or other medication injections into the afflicted nerves. Spinal cord stimulation, peripheral nerve stimulation, and brain stimulation can all be used to treat neuropathic pain that has not responded to the aforementioned treatments.
Despite being challenging to entirely cure, neuropathic pain rarely poses a life-threatening hazard. Combining rehabilitation with assistance for your emotional, social, and mental health will yield the best outcomes. With the assistance of a pain specialist employing some or all of the approaches outlined above, you will be able to control your pain to a level that improves your quality of life.